Digital divide and the health of internal elderly migrants in China: A cross-sectional study

Population aging and internal migration have become the "norm" in China's population development. Influenced by both "mobility" and "old age," internal elderly migrants (IEMs) face the second-level digital divide problems primarily characterized by digital technology usage gap, which can lead to adverse health outcomes. Understanding the impact of the digital divide on the health of IEMs can provide effective solutions to meet the health needs of this particular group and facilitate their better integration into a digital society. Therefore, this study aims at exploring the impact of the digital divide on the health of IEMs, and identifying priorities and recommendations for improving IEMs' health by mitigating the adverse effects of the digital divide.

In the 2017 China Migrant Dynamic Survey (CMDS), a cross‑sectional sample of 169,989 internal migrants in 32 provincial units across China was recruited by stratified probability proportionate to size sampling (PPS). We focus on IEMs and require interviewees to be 60 years and older. Therefore, we excluded samples younger than 60 years of age and retained only 6,478 valid samples. Subsequently, STATA 17.0 software was applied to analyze the data. Based on the research objective and Grossman's model of health demand, we empirically tested using ordered logit regression.

The digital divide does affect the health of IEMs in general and its negative effects tend to decrease significantly with age. In terms of groups, its impact showed noticeable group differences in residence arrangement, public health services and medical insurance coverage. Compared with IEMs who live alone or only live with their spouse, have not received public health service, and have not been covered by any medical insurance, the digital divide imposes a smaller adverse impact on the health of IEMs who live with at least one offspring, have received public health service, and have covered in at least one medical insurance. In terms of potential mechanisms, among the effects of digital divide on the health of IEMs, the mediating effect of urban integration is not significant, the social interaction has only a partial mediating effect, and the medical convenience has a significant mediating effect.

Our findings confirm the existence of the third-level digital divide among IEMs concerning health, that is, the digital divide has adverse health outcomes for this group, and underscore the important implications of reducing the negative impact of the digital divide in improving the health status of IEMs.